'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Hunt orders 'pause' of all new contracts with GP IT supplier following QRISK errors

Exclusive Jeremy Hunt has personally ordered all NHS bodies to temporarily pause negotiations of new contracts with GP IT provider TPP, after Pulse revealed patients may have missed out on statins treatment due to errors in the QRISK2 calculator.

NHS commissioners have been sent the alert from the health secretary and the DH told Pulse that ‘any new contracts being negotiated with [TPP] are under review’ while the issue with QRISK2 is being investigated.

The ordered pause will not affect existing contracts, and TPP told Pulse that it hoped to have resolved the issues shortly.

Pulse revealed problems identified in practices using the QRISK2 calculator in the SystmOne GP IT software, some of which date back to 2009.

Risk scores have been both underestimated and overestimated, meaning some patients at risk of heart attack or stroke may not have been given preventive treatment, while others may have been treated unnecessarily.

The alert, circulated to NHS organisations and sent by Department of Health information policy officer David Knight, says NHS managers ‘may be aware of the current issue’ with TPP systems.

It adds that SystmOne runs in 30-40% of GP practices, though TPP’s website puts the figure at 2,500 practices.

The alert states: ‘The Secretary of State and Perm Sec [permanent secretary Una O’Brien] have asked that any contracts which may be about to be signed with TPP should be “paused” until the current issue is resolved. (Existing contracts already signed will be unaffected.)

‘We know that MHRA and NHSE have been discussing new contracts with TPP but there are probably others in the health and care system.’

The directive also tasks the heads of NHS ‘arms-length bodies’ – including NHS England and the CQC – with updating the DH on any negotiations that might be in the works.

A copy of the alert seen by Pulse had been circulated to CCG leaders by NHS England regional team primary care leads.

CCGs and practices were negotiating and re-signing or changing provider during the start of 2016, but the ordered ‘pause’ will not affect contracts that have already been agreed.

A TPP spokesperson told Pulse: ‘TPP is aware of the communication circulated by the Department of Health. This temporary pause does not affect existing contracts and we are working to be the best of our ability to resolve the issue as soon as is possible, and expect the temporary pause to be lifted following the resolution.’

TPP added that it had responded ‘immediately’ once issues were identified with the QRISK2 calculator, and Pulse has reported that the tool has since been blocked in SystmOne.

The spokesperson said: ‘TPP responded immediately once issues were identified with the QRISK2 calculator, an advisory, third-party tool which was adapted by TPP to be integrated into SystmOne. We are currently working to verify that the QRISK2 calculator is functioning correctly, with the guidance of MHRA and HSCIC.’

An MHRA spokesperson said patients should continue taking medicines as prescribed, and should raise any questions with their GP at ‘their next routine review’, adding: ‘We continue to work with TPP to address, as a matter of urgency, the issue with their adapted calculator and to ensure all remedial actions have been taken.’

A DH spokesperson told Pulse: ‘MHRA is working closely with the company responsible to resolve the incident and any new contracts being negotiated with that company are under review.’

If the problem dated back to 2009 undetected it shows how good they are. Now they run in 30% to 40% of GP Practises they've only found 20 patients impacted per practise! Sounds like the usual arrogance, more like millions of records impacted if you do the math from the article.

I am confused. GP records are confidential. How can TPP send "each GP partner in SystmOne practices had been sent lists of around 20 patients who had received incorrect risk scores and needed a review." Surely this means that they can access the detailed, identified records. Who else can access the records?

Anonymous
| Work for a health/commissioning consultancy company25 May 2016 1:57pm

I agree with P George Paige. Just how much access to confidential patient records do they have! Wonder if their developers analysed the records affected and how do they have a legitimate relationship with the patients? Surely this is yet another issue.